Endoscopic technique has been used in the management of comminuted malar fractures. However, the reported dissection plane is close to the frontal branch of the facial nerve, and paralysis of the frontal muscle is sometimes noted postoperatively. From January 1998 to November 2001, 42 patients underwent endoscopic-assisted zygomatic bone repair at Kaohsiung Medical University Hospital and Kaohsiung Municipal Hsiao Kang Hospital. The zygomatic arch was approached via a dissection plane beneath the deep temporal fascia, and the plate was fixed on the upper border of the arch. The advantages of this method are 1) one temporal incision is sufficient for dealing with the zygomatic arch fracture; 2) the learning curve for endoscopic technique is shortened; 3) there is less risk of injury to the frontal branch of the facial nerve; and 4) the periosteum at the anterior and inferior border of the zygomatic arch is preserved. The deep method is a safe alternative for endoscopic-assisted comminuted malar fracture repair.
Forty-two endoscope-assisted zygomatic fracture repairs were performed by dissecting beneath the deep temporal fascia and securing the plate on the upper border of the arch. Advantages of this method include access through a single temporal incision, less risk of injury to the frontal branch of the facial nerve, and preservation of periosteum.
*Division of Plastic and Reconstructive Surgery, Department of Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University; and †Department of Surgery, Kaohsiung Municipal HsiaoKang Hospital, Kaohsiung, Taiwan.
Received Jan 8, 2002, and
in revised form Mar 26, 2002.
Accepted for publication Mar 26, 2002.
Address correspondence and reprint requests to Dr Sin-Daw Lin, Division of Plastic and Reconstructive Surgery, Chung-Ho Memorial Hospital, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
Presented at the 9th International Congress of the International Society of Craniofacial Surgery; Visby, Sweden; June 17–20, 2001.
Lee S-S, Lin S-D, Chiu Y-T, Tsai C-C, Lin T-M, Chang K-P. Deep dissection plane for endoscopic-assisted comminuted malar fracture repair.